Emergency calls concerning older patients: Are the appropriate questions asked?

AIM

In the present study, we evaluated the triage process particularly for older patients after calls to Emergency Medical Call Centers (ECC), according to the geriatric assessment tool.

METHODS

In this observational population-based cross-sectional study in the Rhône (France), we analyzed the audiotapes of all calls received by ECC concerning patients aged ≥75 years, during seven randomly selected days, over a period of 1 year. We analyzed whether information about seven key items, predefined by a panel of experts as essential for quality telephone triage of seniors, was actually collected.

RESULTS

Among 4168 calls, 712 (17.1%) concerned patients >75 years (mean ± SD, age 84.6 ± 5.6 years). The mean duration of calls was 3 min 28 s. Information about living arrangements (alone or not), dependency, multiple pathologies, polymedication, ability to walk independently or with help, and hospitalization in the previous 3 months was not collected in 20%, 42%, 40%, 45%, 58% and 61% of calls, respectively. All seven geriatric items were collected for only 54 (7.8%) calls, and only three criteria collected for 277 (40%) calls. Nurse-managed calls were significantly associated with the collection of less geriatric items compared with physician-managed calls.

CONCLUSION

Key information is particularly important to guide the orientation, and further management of older patients may be lacking during the telephone triage of patients in ECCs. This may represent an important level of improvement of the triage process, to address the needs of older patients better and avoid inappropriate emergency department visits. Geriatr Gerontol Int 2023; 23: 54-59.